Provider Demographics
NPI:1093932204
Name:HUNTER, CAROLYN (DMD)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:
Last Name:HUNTER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:M
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 396
Mailing Address - Street 2:
Mailing Address - City:CASSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65625-0396
Mailing Address - Country:US
Mailing Address - Phone:417-847-2461
Mailing Address - Fax:417-847-4005
Practice Address - Street 1:77 SMITHSON DR
Practice Address - Street 2:
Practice Address - City:CASSVILLE
Practice Address - State:MO
Practice Address - Zip Code:65625-9429
Practice Address - Country:US
Practice Address - Phone:417-847-2461
Practice Address - Fax:417-847-4005
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO139911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice